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Take care

By Adam Taor

ANTICANCER drugs may be causing miscarriages in women who mix and administer
them, according to a new analysis of a survey of healthcare professionals in the
US. The female partners of men who handle these toxic drugs may also be at
risk.

The dozens of chemotherapy agents now in use around the world treat cancer by
targeting rapidly dividing cells. Researchers suspect they can cause
miscarriages either by harming the fetus itself, or by damaging sperm or eggs so
that they produce a non-viable embryo, says Barbara Valanis of the Kaiser
Permanente Center for Health Research in Portland, Oregon, who lead the research
team.

Although hospital staff usually wear gloves and masks when handling these
drugs, Valanis suspected that some people would still be exposed: “People are
not as careful as they ought to be when handling these drugs,” she says. So
miscarriage rates should be higher for more frequent handlers, she reasoned.

Valanis and her colleagues compiled drug-handling figures from an extensive
survey of healthcare workers at hospitals across the US which was taken in 1989.
They compared rates of miscarriage among roughly 2700 women who had mixed or
administered anticancer agents or who had cleaned chemotherapy patients’
bedpans. They also looked at miscarriages among several hundred partners of male
staff. In all, the groups of workers reported around 7000 pregnancies with 800
miscarriages.

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As the researchers report in the current Journal of Occupational and
Environmental Medicine (vol 41, p 632), women exposed to anticancer drugs
during or shortly before pregnancy were 1.5 times more likely to have a
miscarriage than women who did not handle drugs around the time of their
pregnancy. They also found a weaker correlation among the partners of men who
handled the drugs.

According to Valanis, staff are not always as cautious as they should be when
handling anticancer drugs. They may leave off protective clothing to avoid
unnerving the patient, for example. Or they may become careless because it was
routine.

Howard Mason, a principal scientist at the Health and Safety Laboratory in
Sheffield, who is in charge of a series of studies on exposure to anticancer
drugs, says although handling practices have improved in Britain—and
perhaps in the US as well—since the survey was done there is still reason
to believe that pregnant women are being exposed. For instance, a growing number
of cancer patients now receive their treatment at home, where there are fewer
safe-guards and more non-professional carers. “Obviously we have to be
concerned about that,” he says.